Bullying Survey

You may select more than one answer on some of the questions.
Name: 


A red asterisk (*) indicates required questions.

  1. Have you ever been bullied?*
    Yes
    No


  1. If you answered yes, how often did someone bully you?*
    Occasionally
    Often
    Every day
    Does not apply


  1. Where did it happen? Choose all that apply.*
    School
    Park
    Home
    Neighborhood
    Somewhere else
    Does not apply


  1. If it happened at school, where? Choose all that apply.*
    Hallway
    Classroom
    Plaground
    Lunch area
    Bathroom
    Somewhere else
    Does not apply


  1. Have you seen others being bullied?*
    Yes
    No


  1. If you answered yes, how often did it happen? *
    Occasionally
    Often
    Every day
    Does not apply


  1. Where have you seen others bullied? Choose all that apply.*
    Hallway
    Classroom
    Playground
    Lunch area
    Bathroom
    Somewhere else
    Does not apply


  1. What kinds of things have bullies done to you or someone you know? Choose all that apply.*
    Called names
    Threatened
    Stole or damaged something
    Shoved, kicked, or hit
    Ignored
    Something else
    Does not apply


  1. How much of a problem is bullying for you?*
    Very much
    Not much
    None


  1. List some of the actions you think parents, teachers, and other adults could perform to stop bullying.
    *